| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROGER BOUCHARD INSURANCE INC3 | 8191 COLLEGE PKWY STE 202 FORT MYERS, FL 33919 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $4K | $4K | 1.74% |
| MERITAIN HEALTH3 Filed as: MERITAIN HEALTH INC | 300 CORPORATE PKWY AMHERST, NY 14226 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $2K | $2K | 0.72% |
| ROGER BOUCHARD INSURANCE INC3 Filed as: ROGER BOUCHARD INS INC | PO BOX 6090 CLEARWATER, FL 33758 | UNION SECURITY INSURANCE COMPANY | $7K | — | $7K | 10.00% |
| ROGER BOUCHARD INSURANCE INC3 | 101 STARCREST DR CLEARWATER, FL 337653225 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $2K | $5K | 9.32% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 2.88% |
| ROGER BOUCHARD INSURANCE INC3 | 101 STARCREST DR CLEARWATER, FL 337653225 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $2K | $4K | 9.44% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 2.96% |
| ROGER BOUCHARD INSURANCE INC3 | 101 STARCREST DR CLEARWATER, FL 337653225 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $916 | $2K | 8.92% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $610 | $610 | 2.61% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MERITAN HEALTH EIN 16-1264154 CLAIMS PROCESSING | Claims processing Service code 12 | — | $168K |
| SCRIP WORLD, LLC EIN 87-0632355 RX POLICY | Claims processing Service code 12 | — | $130K |
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 292 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 294 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNION SECURITY INSURANCE COMPANY | 159 | $67K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 294 | $72K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 68 | $45K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 211 | $225K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 294 | $49K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 294 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.